Women less likely to receive CPR

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March 01, 2024

2 min read

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Women with public cardiac arrest less likely than men to receive CPR

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Key takeaways:

  • Women were less likely than men to receive bystander CPR after a public out-of-hospital cardiac arrest.

  • Findings did not change in analyses by neighborhood composition.

Women who experience cardiac arrest in public locationshave a decreased likelihood of receiving bystander CPR and automated external defibrillator application than men, regardless of neighborhood race composition, researchers reported.

In a retrospective study using the Cardiac Arrest Registry to Enhance Survival (CARES) database, researchers also found that the observed sex differences were not seen when examining survival to hospital discharge, suggesting a need for targeted education strategies and public health community programming to reduce bystander response disparities.

Women were less likely than men to receive bystander CPR after a public out-of-hospital cardiac arrest. Image: Adobe Stock

“Females are less likely than males to receive bystander CPR despite neighborhood composition,” Audrey L. Blewer, PhD, MPH, assistant professor of family medicine and community health and population health sciences at Duke University School of Medicine, told Healio. “We need to promote the public message that anyone can save a life. When someone encounters a cardiac arrest, they need to call 911, push hard and fast on the center of the person’s chest, and use a defibrillator (shock box) if available. Receipt of CPR should not differ based on the sex of the person having a cardiac arrest.”

Audrey L. Blewer

Blewer and colleagues analyzed CARES data to assess 309,662 adult out-of-hospital cardiac arrests not witnessed by emergency medical services (EMS) personnel from 2013 to 2019, with data stratified by neighborhood composition using U.S. Census Bureau information. The CARES registry includes all nontraumatic out-of-hospital cardiac arrests in which resuscitation was attempted by a 911 responder, including CPR, defibrillation or both. The mean age of patients was 62 years; 36% were women and 21% were Black.

The primary outcome was odds of receipt of bystander CPR stratified by sex and location, considering neighborhood-level race or ethnicity. Secondary outcomes were AED application and survival to hospital discharge.

The findings were published in the Journal of the American Heart Association.

Within the cohort, 39% received bystander CPR, 39% received AED application and 10% survived to hospital discharge. Twenty percent of arrests occurred in predominantly Black neighborhoods and 19% occurred in predominantly Hispanic neighborhoods.

Among adults who experienced public out-of-hospital cardiac arrest, 43% of women and 47% of men received bystander CPR (P < .001). Researchers found that women who had an out-of-hospital cardiac arrest were 14% less likely to receive bystander CPR than men (OR = 0.86; 95% CI, 0.82-0.89).

Analyses that incorporated neighborhood composition did not change the findings. ORs for women vs. men receiving bystander CPR after a public cardiac arrest were 0.8 for predominantly white neighborhoods (95% CI, 0.75-0.85), 0.87 for predominantly Black neighborhoods (95% CI, 0.76-0.98) and 0.83 for predominantly Hispanic neighborhoods (95% CI, 0.73-0.96). Sex-based differences were similar when assessing AED application after a public cardiac arrest.

In contrast, compared with men, women were more likely to survive to hospital discharge in both predominantly white and predominantly Black neighborhoods.

“There is a critical need to understand the potential sources of bias that may impact the receipt of CPR by females in the public setting,” Blewer told Healio.

The researchers noted that additional language may need to be incorporated into the bystander CPR trainingcurriculum to remove potential biases or fears of performing bystander CPR in public on women, adding that a recent study suggested respondents feared inappropriately touching the woman or harming her.

“Tailoring CPR training curriculum to address some of these issues may help reduce known inequities,” the researchers wrote. “Furthermore, the American Heart Association is looking specifically at these sex-based issues and has included additional materials in courses to address these barriers.”

For more information:

Audrey L. Blewer, PhD, MPH, can be reached at audrey.blewer@duke.edu; X (twitter): @audreyblewer.

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Madison Police Officers receive Lifesaving Medal

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For some of us, getting the email notification that we won’t be going in to work due to weather is a welcome alert on our phones. But for Sgt. Ricardo McCants, Officer Jeff Landrom, and Officer Shannon DeFazio, that alert doesn’t apply. On February 16, 2021, just after these three Madison police officers reported for duty with the prediction of an approaching winter storm, getting a weather day was the last thing on their minds. However, for Madison resident Chris Snipes and his wife Tracy, the morning that started as an icy day off was extraordinary beyond any snow storm that could have been predicted. 

On a normal day, Chris would have been headed to the gym and then on to work as a Program Manager for the U.S. Army. But on this icy, cold morning, he was in his kitchen when he suddenly collapsed. Hearing him fall, Tracy ran to his aid and found him unresponsive on the floor. She immediately dialed 911 and began chest compressions on her husband of 25 years. Brief minutes become what seems like hours waiting to hear the wail of sirens bringing help but Tracy continued CPR until Madison Police Officers arrived. Officer Jeff Landrom immediately jumped into action and Tracy recalls that when she looked around and “saw the size of his arms”, she knew her husband was in good hands. Without hesitation, Officer Landrum, Officer Shannon DeFazio, and Sgt. Ricardo McCants began lifesaving measures to keep Chris alive until HEMSI and Madison Fire and Rescue personnel could arrive on scene. 

Chris was loaded into an ambulance and transported to the hospital where he was placed on “hypothermic protocol” for two days allowing his heart to recover from the episode of ventricular fibrillation that almost took his life. After three days under this protocol, Chris was finally able to Zoom call with his wife. He still has no recollection of any of the events that occurred on February 16. 

Officers Landrum and DeFazio and Sgt. McCants were starting their shift when this 911 call for help came in thirty minutes after they signed on for the day. Officer Landrom recalls replaying the entire call in his head and worrying if he had “done it all right”. Tracy Snipes says, he definitely did everything right and just his calm presence brought her peace and confidence in his abilities. As Chris was transported to the hospital that icy morning, Officer Landrom drove Tracy to the hospital not knowing if his efforts had been successful or if he might be driving into a situation that was even more difficult. As it turns out, the efforts of Tracy, the 911 call taker, MPD officers, Madison Fire and Rescue, and HEMSI personnel all worked together seamlessly to get Chris to the hospital where he received lifesaving care. 

On Monday, March 1, 2021, a mere 13 days after surviving a near fatal cardiac emergency, Chris and Tracy Snipes came into the Madison Police Department to show their gratitude and appreciation to the officers credited with saving Chris’ life. It is not often that officers get to see the benefit of their commitment and hard work, but on this day, it was very clear that their training and dedication paid off.  

The Madison Police Department was honored to present Officer Jeff Landrom, Officer Shannon DeFazio, and Sgt. Ricardo McCants with a Lifesaving Medal at the City Council meeting held March 8, 2021.
Thank you to Chris and Tracy Snipes for allowing us the privilege of serving you and sharing your story.

9 Mar · Subscribers of Madison Police Department in General

Discriminatory cardiac arrest care? Patients with low socioeconomic status receive delayed cardiopulmonary resuscitation and are less likely to survive an in-hospital cardiac arrest

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European Heart Journal, Volume 42, Issue 8, 21 February 2021, Pages 861–869

Jens Agerström, Magnus Carlsson, Anders Bremer, Johan Herlitz, Johan Israelsson, Kristofer Årestedt

Abstract

Aims

Individuals with low socioeconomic status (SES) face widespread prejudice in society. Whether SES disparities exist in treatment and survival following in-hospital cardiac arrest (IHCA) is unclear. The aim of the current retrospective registry study was to examine SES disparities in IHCA treatment and survival, assessing SES at the patient level, and adjusting for major demographic, clinical, and contextual factors.

Methods and results

In total, 24 217 IHCAs from the Swedish Register of Cardiopulmonary Resuscitation were analysed. Education and income constituted SES proxies. Controlling for age, gender, ethnicity, comorbidity, heart rhythm, aetiology, hospital, and year, primary analyses showed that high (vs. low) SES patients were significantly less likely to receive delayed cardiopulmonary resuscitation (CPR) (highly educated: OR = 0.89, and high income: OR = 0.98). Furthermore, patients with high SES were significantly more likely to survive CPR (high income: OR = 1.02), to survive to hospital discharge with good neurological outcome (highly educated: OR = 1.27; high income: OR = 1.06), and to survive to 30 days (highly educated: OR = 1.21; and high income: OR = 1.05). Secondary analyses showed that patients with high SES were also significantly more likely to receive prophylactic heart rhythm monitoring (highly educated: OR = 1.16; high income: OR = 1.02), and this seems to partially explain the observed SES differences in CPR delay.

Conclusion

There are clear SES differences in IHCA treatment and survival, even when controlling for major sociodemographic, clinical, and contextual factors. This suggests that patients with low SES could be subject to discrimination when suffering IHCA.

A Story With Heart: 14-Year-Old Saved by CPR-Performing Tourist Receives Pacemaker & Bright Future By Cammy Clark January 27, 2021, 2:44 PM HST

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The sun had set and darkness was arriving fast on Jan. 19 when tourist Ryan Ostrander and his wife saw a teenaged girl dragging another teenaged girl out of the water at a nearly deserted Kahana Beach in West Maui.

“It was odd, but are they playing?” Ostrander wondered until he saw a woman run to help and his wife heard cries to call 9-1-1.

From the balcony of his fifth-floor hotel room, Ostrander sprinted to the stairwell, took the steps two at time, jumped a small seawall and arrived at the beach to find the girl “basically dead.”

“No breathing. No pulse. Really scary,” Ostrander said. “The grandma was terrified.”

The heart had stopped of 14-year-old Naiya Eide, causing her to go unconscious in hip deep water. But the eighth-grader at Lāhainā Intermediate School now is looking forward to a future involving photography, traveling the world and more backflips due to the quick actions of Ostrander, her friend, her grandmother and the ambulance crew.

Wednesday morning, a week after her cardiac arrest, Naiya underwent successful surgery at Straub Medical Center in Honolulu to put in a pacemaker and defibrillator.

Hands Only CPR for Adults

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Call 911 if a person:

  • Collapses

  • Becomes unresponsive

1. Check Responsiveness

  • Tap the person's shoulder and shout, "Are you OK?"

  • Look for normal breathing. Call 911 if there is no response.

  • Start Hands-Only CPR.

  • Hands-Only CPR should not be used for adults whose cardiac arrest is due to drug overdose, near-drowning, or an unwitnessed cardiac arrest. In these cases, do a conventional CPR combination of chest compressions and rescue breathing.

2. Do Chest Compressions

  • Place the heel of your hand on the center of the person's chest.

  • Place the heel of your other hand on top of your first hand, lacing fingers together.

  • Keep arms straight and your shoulders directly over your hands.

  • Push hard and fast, compressing chest at least 2 inches.

  • Let chest rise completely before pushing down again.

  • Compress at least 100 times per minute.

3. Stop Only if:

  • The person starts breathing normally.

  • A trained responder or emergency help takes over.

  • You are too exhausted to continue.

4. Use an AED as Soon as One Is Available

  • Turn on the AED. It will give you step-by-step instructions.

  • Wipe chest dry.

  • Attach the pads.

  • Plug in connector, if needed.

  • Make sure no one is touching the person. Say "Clear" so that people know to stay back and not touch the person.

  • Push the "Analyze" button if necessary.

  • If a shock is advised, push the "Shock" button.

  • Resume compressions and follow AED prompts.There is an automated external defibrillator (AED) to use.



 Marathon Runner Loses Consciousness

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Instead of celebrating, Kyle Woods was transported to the hospital soon after he crossed the finish line for his first half-marathon. Doctors still don’t know why, but 24-year-old Woods passed out and went into full cardiac arrest on the asphalt. A team of six emergency personnel took turns performing chest compressions and sending electric shocks through a defibrillator to his heart. After 12 minutes, Woods’ heart finally started beating. Today,  the marathon runner owes his life to the UCHealth medical team who were stationed near the finish line. If they hadn’t been trained in CPR and been readily available, the completion of Woods’ first half-marathon would’ve had a different ending.

Dr. Oz saved a man who collapsed at a New York City area airport

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(CNN)Dr. Mehmet Oz sprang into action and helped save a man who had collapsed at an airport Monday night. 

Oz, along with Port Authority police, performed CPR on a 60-year-old man at Newark Liberty International Airport in New Jersey, according to a statement from the Port Authority Police Department.

"I performed CPR with the help of a Newark Port Authority police officer and cleared the man's airway," Oz tweeted. "Thankfully, the airport had a defibrillator nearby that we were able to use to save his life."

"At approximately 11:07 p.m. last night, Port Authority Officer Jeffrey Croissant was on patrol when he witnessed a man fall to the floor in the baggage claim area in Terminal A at Newark Liberty International Airport. Officer Croissant rushed to the man who was not breathing and did not have a pulse," the Port Authority statement read in part.

"Officer Croissant called for back-up immediately and began CPR on the man. At that same time, Celebrity TV doctor, Dr. OZ, was at the carousel, took notice of the emergency and rushed over to work together with Officer Croissant to perform CPR."

The 60-year old New Jersey resident was transported to the hospital in intensive care and is undergoing further evaluation.

After working late, teacher woke up in ICU 4 days later

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By Suzanne Marta, American Heart Association News

Teacher Zach Nelson spent most of his Sunday preparing for the week ahead, working deep into the evening. He put his 5-year-old son to bed, then returned to his laptop to continue with his lesson plans.

Zach felt tired, even dozing off a few times. But it was late, so each time he awoke, it made sense.

Then he awoke in the intensive care unit. Four days later. That made no sense.

On Jan. 22, 2017, Zach's wife, Leah, had gone to bed but was restless waiting for him to join her. Then she heard what sounded like a choking sound. Thinking it was the couple's dog Ike, Leah called for Zach to check on him.

When Zach didn't answer, Leah – who was nearly 6 months pregnant – went out to investigate. She found her husband in his recliner, gasping and shaking. Thinking it may be a seizure, Leah, a nurse, ran for her phone, called 911 and dashed back to Zach, whose face had turned blue.

Realizing he wasn't breathing and that his heart had stopped, she dragged him to the floor and began CPR. She kept 911 dispatchers on the line and shouted for their son to unlock the front door.

Help arrived within minutes, only it wasn't paramedics. It was two neighbors – a nurse and a volunteer firefighter who heard the dispatch call. They relieved Leah until the ambulance arrived.

The EMS crew used a defibrillator to shock Zach's heart into a normal rhythm before transporting him to their local hospital in Hays, Kansas. He was then flown to the University of Kansas Hospital in Kansas City, nearly four hours away.

For the next few days, Zach underwent more tests, but doctors were unable to determine what went wrong with the electrical system of the 31-year-old's heart. Genetic testing also failed to reveal any answers.

Zach received an implantable cardioverter defibrillator, a device that would shock his heart back into rhythm if needed. He's been fine ever since.

Now an elementary school gym teacher in Horton, Kansas, Zach talks to students about heart health. Last school year, he led the school in the American Heart Association's Kids Heart Challenge. A couple times a year, he explains his ICD and creates a plan with his students so they know how to get help if he – or anyone else – ever needs it.

Three MPD officers receive Lifesaving Medal

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On November 17, 2019, Officer Jonathan Siskoff has dispatched to the 100 block of Royal Drive for an unresponsive male. Upon contact, Officer Siskoff located the victim lying on his back on the sidewalk in front of an apartment building. Officer Siskoff performed an emergency assessment of the victim which determined the victim had no pulse and was not breathing. Officer Siskoff immediately initiated CPR and performed chest compressions for several minutes until the victim regained a pulse and was breathing. The victim was transported to Huntsville Hospital and made a full recovery. On November 20, 2019, Officer Jeremy McKinney and Andrew Bates were dispatched to the Woodspring Suites for an unresponsive male. Upon contact, the officers found a victim lying on his back on the bathroom floor. Both officers performed an emergency assessment of the victim determining he was not breathing and had no pulse. Officer McKinney and Bates sprang into action pulling the victim from the bathroom into the foyer. They immediately initiated CPR alternating as they performed chest compressions for several minutes until the victim regained a pulse and was breathing on his own. The victim was transported to Huntsville Hospital and made a full recovery.

Local Officer Was 911Ready

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Officer Russell Owens of Madison (AL) Police Department received the Life Saving Award for his efforts helping a sudden cardiac arrest (“SCA”) victim.

 On July 1, Madison police officers responded to a medical call for a person in distress. Owens was the first officer on scene and found a 23-year-old male who was in full cardiac arrest.  Owens started CPR procedures and continued to provide lifesaving efforts for about three minutes until EMS arrived.

 Madison Police Department’s Life Saving Award was given “Due to the swift and decisive actions of Officer Owens, a life was saved and the patient able to make a recovery,”

By being 911Ready, Officer Owens was able to save the life of another person.  Get trained in CPR and AED use…unlike Officer Owens situation, the most likely person you will save will be a family member, friend, or business associate.

 

 

(Read the whole story here)